Provider Demographics
NPI:1336849033
Name:BARNUM, KENDRA D (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:D
Last Name:BARNUM
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 N ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1557
Mailing Address - Country:US
Mailing Address - Phone:405-388-4130
Mailing Address - Fax:
Practice Address - Street 1:5800 GRANITE PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6619
Practice Address - Country:US
Practice Address - Phone:405-317-2610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist